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Scores on the Patient Health Questionnaire–9 (PHQ-9) are frequently used to assess depression both in research and in clinical practice. The aim was to examine the validity of the PHQ-9 sum score by using Mokken scale analysis (Study I) and cognitive interviews (Study II) on the Icelandic version of PHQ-9. A primary care sample of 618 individuals was used in Study I. The results indicate that the PHQ-9 items are not close enough to perfectly unidimensional for their sum score to accurately order people on the depression severity dimension. In Study II, the sample consisted of 53 individuals, with 28 having a history of depression and 25 not. The findings reveal a number of issues concerning respondents' use of the PHQ-9. No systematic differences were found in the results of the two groups. The PHQ-9 sum score should thus be interpreted and used with great care. We provide scale revision recommendations to improve the quality of PHQ-9. [ABSTRACT FROM AUTHOR]

Athletes' goal orientations have been associated with a wide array of sport-related behaviors, thoughts, and perceptions. The two main goal orientations defined in the achievement goal theory framework are task and ego orientations. The task and ego orientation questionnaire (TEOSQ) was developed to assess levels of task and ego goal orientations in sport-related settings and is widely used in research in the field of sport psychology. Its use in research rests on the assumption that sum scores of the TEOSQ can be used to order individuals by their levels of the two goal orientations. In this study, the soundness of this assumption is evaluated using Mokken scale analysis (MSA). TEOSQ responses from 749 football players were used in the analysis. Both the monotone homogeneity model and the double monotonicity model were fitted. The scalability coefficients for both the task and ego orientation subscales were 0.45 indicating a moderately good scalability. Invariant item ordering did not hold for either of the two subscales. There is definite room for improvement in the TEOSQ. Several improvement suggestions are made and further research directions are discussed. [ABSTRACT FROM AUTHOR]

The objective of the study was to examine the relationship between self-reported concussion history and stress, depression, anxiety, and quality of life among Icelandic female athletes. Participants were 508 Icelandic female athletes, aged 18–45 (M = 26.99, SD = 7.14), that had, or were currently training and competing in the two top leagues in basketball, soccer, and handball, in the top league in ice-hockey and national tournaments in mixed martial arts, taekwondo, karate, and boxing. Participants completed an online questionnaire regarding their age, sport, and concussion history before answering standard mental health scales concerning stress (PSS), depression (PHQ-9), anxiety (GAD-7), and quality of life (QOLS). Female athletes reporting a history of concussions scored higher on PSS, PHQ-9, and GAD-7 than those reporting no history of concussion. Scores on the QOLS were not significantly different between the groups. Female athletes that had sustained a concussion were 3.48 to 4.85 times more likely (depending on the number of concussions) to score above the clinical cut-off on PHQ-9 than those that had not sustained a concussion. Athletes that reported 2–3 or ≥ 4 concussions were 3.52 and 3.40 times more likely to score above the clinical cut-off on GAD-7, respectively. Results indicate that Icelandic female athletes with a history of concussion report more symptoms of distress than those with no history of concussion, and the higher number of concussions sustained, the worse they feel. [ABSTRACT FROM AUTHOR]

This study's objectives were to analyse goal orientation and motivational climate in elite handball players as functions of age and gender; and construct a multivariate model explaining handball performance from a motivational perspective (orientation and climate). The participants were 174 national team handball players. They were categorized in accordance with the official age groups. Two questionnaires were used: Task and Ego Orientation in Sport Questionnaire and the Perceived Motivational Climate in Sport Questionnaire-2. A one-way ANOVA (Bonferroni post-hoc correction) was used to examine differences between teams for each gender. Discriminant analyses were performed to classify the participants of each team into two groups according to their performance level (starters and non-starters). There were no age or gender differences found in goal orientation, and very few differences in motivational climate. Except for the women's U19, U17, and U15 teams, it was possible to predict the performance level (starters and non-starters) in the different age and gender groups, achieving correct classification (55% to 93%). The two variables that were repeated most often (thrice) in the models were ego orientation and task cooperative learning. Coaches might focus on looking for handball players with ego orientation, while a climate of task-oriented motivation should predominate in training sessions. [ABSTRACT FROM AUTHOR]

The objectives of this study were (i) to analyse how differences in psychological skills among elite athletes depend on sex and psychological skills training (PST), and (ii) to identify predictors of whether an elite athlete has sought PST. Three hundred and ninety-six Icelandic members of youth and senior national teams (49.2% men 21.4 ± 7.1 years old) in basketball, equestrian sports, football, golf, handball and weightlifting participated in the study. The participants completed a background information questionnaire and the Test of Performance Strategies questionnaire (TOPS). The former collected information about age, sex, sport practiced, and whether or not the respondent used or was interested in using PST. The latter assessed the psychological skills the respondent used in training and competition. An independent-samples t-test was used to compare the means on the TOPS sub-scales between sexes and between the use or not of PST. A forward stepwise logistic regression model was constructed to determine which of the variables (age, sex and TOPS sub-scales) could predict whether or not the sportsperson had used PST. PST was used by 42% of the respondents, but the 90% were interested in this type of training. Golfers used PST the most (56%), and men used PS more than women, especially in competition. It was possible to correctly classify 59% of the cases (23% of the variance explained) as to whether or not the participant used PST using just five variables: relaxation in practice, negative thinking in competition, age, self-talk in competition and imagery in practice. [ABSTRACT FROM AUTHOR]

Background: In recent years, cognitive behavioural group therapies (CBGT) have been increasingly deployed as a strategy to increase the efficiency and cost-effectiveness in treatment of common mental health problems. The vast majority of these therapies are disorder specific, but in the last few years there has been growing interest in transdiagnostic CBGT. Aims: The aim of this study was twofold: to evaluate the treatment effects of transdiagnostic CBGT on disorder specific symptoms and what (if any) differences would be observed in the treatment effects with regard to general as opposed to disorder specific symptoms measured pre- and post-treatment. Method: The participants were 233 adult patients diagnosed with depression and/or anxiety disorders. They underwent a 6-week transdiagnostic CBGT. To compare treatment effects on general and disorder specific symptoms, raw scores on all measures were converted to standardized scores. Results: Pre–post differences were significant and there was no evidence that treatment was differentially effective for general and disorder specific symptoms. Effect sizes ranged from medium to large. Conclusion: The 6-week transdiagnostic CBGT is feasible for a wide range of mood and anxiety disorders. The results indicate that low-intensity transdiagnostic group therapies may have similar effects on both general and disorder specific symptoms. [ABSTRACT FROM AUTHOR]

The aims of this study were (i) to know the effects of an exercise program on a group of people with depression and anxiety and (ii) to compare theses effects with a transdiagnostic cognitive behavioral group therapy (TCBGT). The participants were 15 people with depression and/or anxiety symptoms. The participants followed an exercise program. Depression and anxiety symptoms were assessed with validated questionnaires. An exercise program can be used as a treatment option for people with depression and/or anxiety with good results in comparison with TCBGT. [ABSTRACT FROM AUTHOR]

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Background: The development of initiatives to improve access to psychological therapies has been driven by the realization that untreated anxiety and depression are both very common and costly to individuals as well as society. Effective and efficient treatments, mostly in the form of cognitive behavioural therapies (CBT), can be used in ways which enhance their acceptability and accessibility. To date, numbers of group therapies have been developed to improve cost efficiency, but in spite of growing interest in transdiagnostic approaches, group therapies have so far mostly been diagnosis specific.Aims: This study is aimed at evaluating a brief transdiagnostic cognitive behavioural group therapy (TCBGT) designed to treat both anxiety and depression among patients in primary care.Method: The participants were 287 adult patients in primary care with diagnoses of depression and/or anxiety disorders. They underwent a 5-week TCBGT. A mixed design ANOVA was used to evaluate differential effects of treatment according to diagnostic groups (anxiety versus depression) and number of diagnoses (co-morbidity).Results: Pre–post differences were significant and the treatment was equally effective for both anxiety disorders and depression. Number of diagnoses did not affect the outcome.Conclusions: The study indicates feasibility of the brief transdiagnostic group therapy for a wide range of mood and anxiety disorders in primary care. The results indicate that low intensity, brief transdiagnostic group therapies may be a feasible way to improve access to psychological therapies for a large number of patients. [ABSTRACT FROM PUBLISHER]

Background The development of transdiagnostic standardized measures of psychological distress have contributed to the development of practice-based evidence networks. The translation and validation of such measures cross culturally is important if such research is to be generalized across health care systems in different countries. Method Translation of the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) from English into Icelandic was undertaken according to recommended protocols. The resulting instrument was evaluated for reliability and validity in three groups: patients undergoing psychological treatment in general practice ( n = 289), psychiatric outpatients ( n = 98) and student controls ( n = 207). The Mini-International Neuropsychiatric Interview was administered to the clinical participants. They also completed the CORE-OM and the Beck depression and anxiety inventories before and after treatment. The transdiagnostic relationship between CORE-OM scores and scores on those diagnostic measures was assessed. Results Good levels of validity, reliability and internal consistency were found for the CORE-OM and its domains and sensitivity to change over treatment shown. As anticipated, the risk domain had different characteristics than other domains. CORE-OM scores correlated strongly with both Beck Depression Inventory-Second edition and Beck Anxiety Inventory, particularly the problem domain. Conclusion The Icelandic translation of the CORE-OM is psychometrically sound and can be applied in Icelandic mental health studies as it has been in English speaking settings. Nevertheless, the validity of the Icelandic version of the CORE-OM needs to be further investigated in larger and more diverse samples. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Message The psychometric properties of the Icelandic version of the CORE-OM are comparable with the original English version., The results indicate transdiagnostic utility of the CORE-OM., The CORE-OM is a valuable instrument in outcome research on psychological treatment, specifically transdiagnostic treatment. [ABSTRACT FROM AUTHOR]

The objectives of this study were: (i) to analyse anthropometric parameters, physical fitness, and throwing velocity of youth elite male handball players of different ages; and (ii) to develop a multivariate model that explains throwing velocity. Fifty-three male handball players (17.99±1.68 years old), members of the Icelandic national teams, participated in the study. The participants were classified into the U21 (n=12), U19 (n=17), and U17 (n=24) national teams. All were evaluated by basic anthropometry (body height, body mass, body mass index), physical fitness tests (counter movement jump, medicine ball throw, hand dynamometry, 10 m and 30 m sprint, Yo-Yo IR2 test) and ball velocity after various handball throws at goal (a 7-m throw, a 9-m ground shot after a three-step run-up, and a 9-m jump shot after a three-step approach). A one-way analysis of variance with a Bonferroni post-hoc test was used to establish the differences between the teams. Multiple linear regression was used to predict speed of the ball from each of the three shots taken for each team. There were no differences between the U21 and U19 teams except for the medicine ball throw, but the U19 team scored better than the U17 team in almost all variables. Ball speed after a handball shot was predicted (between 22% and 70% of accuracy) with only one or two physical fitness variables in each model medicine ball throw (in four models), counter movement jump (in two models), and 10 m sprint (in two models), being the variables that were most selective. [ABSTRACT FROM AUTHOR]

Objective: Pituitary dysfunction following mild traumatic brain injury can have serious physical and psychological consequences, making correct diagnosis and treatment essential. To the best of our knowledge, this study is the first to study the prevalence of pituitary dysfunction following mild traumatic brain injury in an all-female population following detailed endocrinological work-up after screening for pituitary dysfunction in female athletes., Design: This is a retrospective cohort study., Methods: Hormone screening blood tests, including serum blood values for thyroid-stimulating hormone, free thyroxin, insulin-like growth factor 1, prolactin, cortisol, follicle-stimulating hormone, luteinizing hormone, estrogen and progesterone, were taken in 133 female athletes. Results were repeatedly outside the reference value in 88 women necessitating further endocrinological evaluation. Two of those were lost to follow-up, and further endocrinological evaluation was performed in 86 participants., Results: Six women (4.6%, n = 131) were diagnosed with hypopituitarism, four (3.1%) with central hypothyroidism and two with growth hormone deficiency (1.5%). Ten women (7.6%) had hyperprolactinemia, and four (3.1%) of them had prolactinoma. Medical treatment was initiated in 13 (9.9%) women. Significant prognostic factors were not found., Conclusions: As 12.2% of female athletes with a history of mild traumatic brain injury had pituitary dysfunction (hypopituitarism 4.6%, hyperprolactinemia 7.6%), we conclude that pituitary dysfunction is an important consideration in post-concussion care. Hyperprolactinemia in the absence of prolactinoma may represent pituitary or hypothalamic injury following mild traumatic brain injury., Significance Statement: Mild traumatic brain injury (mTBI) has become a growing public health concern as 50 million people worldwide sustain a traumatic brain injury annually, with mTBI being the most common (70-90%). As studies on mTBI have focused on mostly male populations this study aims to explore pituitary dysfunction (PD) in female athletes following mTBI. To the best of our knowledge, it is the first all-female study on PD following mTBI. The study found that 12.2% of the participating women had PD after mTBI. Six (4.6%) had hypopituitarism and ten (7.6%) had hyperprolactinemia. These findings suggest that PD following mTBI is an important consideration that endocrinologists and other medical staff working with athletes need to be aware of.